TMD Screening in Elderly Federal University Rio de Janeiro Patients

Screening evaluation may assess symptoms or/and signs but must be simple, easy to apply, present high specificity and sensitivity to detect the clinical problem.

OBJECTIVE: To screen TMD patients of the Odontogeriatric Clinic of the Federal University of Rio de Janeiro, Brazil.

METHODS: 93 consecutive patients (57w;36m; 72y-o, 63-88) answered YES or NO to 3 subjective and 1 objective questions:

1 – Do you feel pain during chewing ?

2 – Can you place 3 finger in the mouth?

3 – Do you hear sounds in front of the ears?

4 – Do you feel pain in the __TMJ or __muscles during palpation?

The masseter and temporal muscles were palpated bilaterally during question 4. Answer YES granted positive finding on all but question 2.

RESULTS:

47% presented positive findings; 26%= one, 15%= two, 5%= three and 1%= four findings. The number of positive findings was correlated with TMD subjective Index. 28% had masticatory pain, 28% articular sounds, 14% artalgia and 11%- mialgia during palpation, 4% limited mouth opening. 24 patients had just one finding; 10-masticatory pain, 8-articular sounds, 4-muscular(3) or articular(2) pain during palpation and 2-limited mouth opening. Among the 26 patients with masticatory pain, 12 had articular sounds, 8-articular(6)/muscular(4) palpation pain, 2-limited mouth opening.

CONCLUSIONS:

The trend for women to seek more treatment than men remained in this elderly sample. About 50%-geriatric dental patients should have a complete TMD examination. Since 6% of the patients - prevalence close to the need for treatment in the population - presented 3-4 findings, the number of positive findings seems to reflect the severity of the multifactorial problem. TMD screening is easy, fast and sensitive to detect patients with signs and symptoms that should be sent for a complete examination, what grant its incorporation into the daily practice.